颗粒物质对于哮喘住院风险的时间变异评估
2017/11/20
摘要
外界环境颗粒物质的增加被认为是导致哮喘或者哮喘类似症状的患病率或者急性发作增加的一大主要原因。最近，提出了颗粒物质对死亡率的风险可能有时间变异。我们研究了PM10和PM2.5对于哮喘住院的短期影响，并且评估了2003-2011年间韩国首尔的PM风险的时间变异。考虑到长期趋势、流行性、每周的天数、气象因素，我们用广义相加模型来估计PM对于哮喘住院的风险。为了评估PM风险的时间变异，我们评估了一整年的PM风险。根据季节以及年龄组进行分层分析。PM增加10㎍/㎥对于哮喘住院的估算RR值在7天延迟期之后分别是1.0084(95% CI: 1.0041-1.0127)和1.0156(95% CI: 1.0055-1.0259)。对于所有年龄组来说PM2.5比PM10的作用更强。老年组最受PM影响。对于PM风险时间变异的分析，我们发现在总体人群以及老年人群中有逐渐增加的趋势。在季节特异性分析中，我们同样发现了PM10在冬天有增加趋势，PM2.5在夏天有增加趋势。PM10 和PM2.5对于哮喘住院有不良影响，有证据表明PM风险有时间变异。需要进一步研究来证实PM对于哮喘住院有时间变异的风险，并且确定偶然的因素影响这种时间变异。这个研究的结果可以作为建立有效的公共卫生政策的证据材料，用来减少哮喘的健康负担或者经济负担。
Assessment of temporal variation for the risk of particulate matters on asthma hospitalization.
Kim H, Kim H, Park YH, Lee JT.
Abstract
Increased ambient concentration of particulate matters are considered as one of major causes for increased prevalence or exacerbation of asthma or asthma like symptoms. Recently, possible temporal variation in risks of PM on mortality has been suggested. We investigated short-term effect of both PM10 and PM2.5 on asthma hospitalization, and assessed temporal variation of PM risks in Seoul, Korea, 2003-2011. Generalized additive model was used to estimate PM risks on asthma hospitalization with consideration by long-term trend, influenza epidemic, day of week, meteorological factors. To assess temporal variation of PM risks, year-round PM risks were estimated. Stratified analysis by season and age-group were also conducted. Estimated RRs of PM on asthma hospitalization by an increase of 10㎍/㎥were 1.0084 (95% CI: 1.0041-1.0127) and 1.0156 (95% CI: 1.0055-1.0259) respectively with 7-days lag periods (lag06). PM2.5 had stronger effect than PM10 for all age group. Elderly group was most affected by PM. For the analysis of temporal variation of PM risks, we found increasing trend in total population and the elderly group. In the season-specific analysis, we also found increasing trend in winter for PM10, and in spring for PM2.5. PM10 and PM2.5 has adverse effect on asthma hospitalization with evidence suggesting temporal variation in PM risks. Further research will be needed to confirm the temporal variation of PM risk on asthma hospitalization, and to identify casual factors affecting this temporal variation. This study results could be evidentiary materials for establishing valid public health policies to reduce health burden or economic burden of asthma.
外界环境颗粒物质的增加被认为是导致哮喘或者哮喘类似症状的患病率或者急性发作增加的一大主要原因。最近，提出了颗粒物质对死亡率的风险可能有时间变异。我们研究了PM10和PM2.5对于哮喘住院的短期影响，并且评估了2003-2011年间韩国首尔的PM风险的时间变异。考虑到长期趋势、流行性、每周的天数、气象因素，我们用广义相加模型来估计PM对于哮喘住院的风险。为了评估PM风险的时间变异，我们评估了一整年的PM风险。根据季节以及年龄组进行分层分析。PM增加10㎍/㎥对于哮喘住院的估算RR值在7天延迟期之后分别是1.0084(95% CI: 1.0041-1.0127)和1.0156(95% CI: 1.0055-1.0259)。对于所有年龄组来说PM2.5比PM10的作用更强。老年组最受PM影响。对于PM风险时间变异的分析，我们发现在总体人群以及老年人群中有逐渐增加的趋势。在季节特异性分析中，我们同样发现了PM10在冬天有增加趋势，PM2.5在夏天有增加趋势。PM10 和PM2.5对于哮喘住院有不良影响，有证据表明PM风险有时间变异。需要进一步研究来证实PM对于哮喘住院有时间变异的风险，并且确定偶然的因素影响这种时间变异。这个研究的结果可以作为建立有效的公共卫生政策的证据材料，用来减少哮喘的健康负担或者经济负担。
（复旦大学附属中山医院呼吸内科 李蕾 摘译 杨冬 审校）
（Environ Res. 2017;156:542-550.）
（Environ Res. 2017;156:542-550.）
Assessment of temporal variation for the risk of particulate matters on asthma hospitalization.
Kim H, Kim H, Park YH, Lee JT.
Abstract
Increased ambient concentration of particulate matters are considered as one of major causes for increased prevalence or exacerbation of asthma or asthma like symptoms. Recently, possible temporal variation in risks of PM on mortality has been suggested. We investigated short-term effect of both PM10 and PM2.5 on asthma hospitalization, and assessed temporal variation of PM risks in Seoul, Korea, 2003-2011. Generalized additive model was used to estimate PM risks on asthma hospitalization with consideration by long-term trend, influenza epidemic, day of week, meteorological factors. To assess temporal variation of PM risks, year-round PM risks were estimated. Stratified analysis by season and age-group were also conducted. Estimated RRs of PM on asthma hospitalization by an increase of 10㎍/㎥were 1.0084 (95% CI: 1.0041-1.0127) and 1.0156 (95% CI: 1.0055-1.0259) respectively with 7-days lag periods (lag06). PM2.5 had stronger effect than PM10 for all age group. Elderly group was most affected by PM. For the analysis of temporal variation of PM risks, we found increasing trend in total population and the elderly group. In the season-specific analysis, we also found increasing trend in winter for PM10, and in spring for PM2.5. PM10 and PM2.5 has adverse effect on asthma hospitalization with evidence suggesting temporal variation in PM risks. Further research will be needed to confirm the temporal variation of PM risk on asthma hospitalization, and to identify casual factors affecting this temporal variation. This study results could be evidentiary materials for establishing valid public health policies to reduce health burden or economic burden of asthma.
